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本文引用的文献

1
Theory-based design and field-testing of an intervention to support women choosing surgery for breast cancer: BresDex.基于理论的设计和干预措施的现场测试，以支持女性选择乳腺癌手术：BresDex。
Patient Educ Couns. 2012 Feb;86(2):179-88. doi: 10.1016/j.pec.2011.04.014. Epub 2011 May 14.
2
Exploring patients' experience of receiving information about cancer: a comparison of interview and questionnaire methods of data collection.探索患者接受癌症信息的体验：访谈和问卷调查数据收集方法的比较。
Health (London). 2011 Mar;15(2):153-72. doi: 10.1177/1363459309360789. Epub 2010 Dec 22.
3
Reporting clinical outcomes of breast reconstruction: a systematic review.报告乳房重建的临床结局：系统评价。
J Natl Cancer Inst. 2011 Jan 5;103(1):31-46. doi: 10.1093/jnci/djq438. Epub 2010 Dec 3.
4
Clinicians' concerns about decision support interventions for patients facing breast cancer surgery options: understanding the challenge of implementing shared decision-making.临床医生对面临乳腺癌手术选择的患者的决策支持干预措施的担忧：理解实施共享决策的挑战。
Health Expect. 2011 Jun;14(2):133-46. doi: 10.1111/j.1369-7625.2010.00633.x. Epub 2010 Oct 28.
5
Assessment of cosmesis after breast reconstruction surgery: a systematic review.乳房重建手术后美容效果评估：系统评价。
Ann Surg Oncol. 2011 Mar;18(3):813-23. doi: 10.1245/s10434-010-1368-6. Epub 2010 Oct 23.
6
Regional variation in use of immediate breast reconstruction after mastectomy for breast cancer in England.英国乳腺癌乳房切除术后即刻乳房重建使用的地域差异。
Eur J Surg Oncol. 2010 Aug;36(8):750-5. doi: 10.1016/j.ejso.2010.06.008. Epub 2010 Jul 6.
7
Computer-based learning module increases shared decision making in breast reconstruction.基于计算机的学习模块增加了乳房重建中的共同决策。
Ann Surg Oncol. 2010 Mar;17(3):738-43. doi: 10.1245/s10434-009-0869-7. Epub 2009 Dec 29.
8
A pilot mixed methods study of patient satisfaction with chiropractic care for back pain.一项关于患者对脊椎按摩疗法治疗背痛满意度的试点混合方法研究。
J Manipulative Physiol Ther. 2008 Oct;31(8):602-10. doi: 10.1016/j.jmpt.2008.09.010.
9
Interactive digital education aid in breast reconstruction.乳房重建中的交互式数字教育辅助工具。
Plast Reconstr Surg. 2008 Sep;122(3):717-724. doi: 10.1097/PRS.0b013e318180ed06.
10
An introduction to reading and appraising qualitative research.定性研究的阅读与评价入门
BMJ. 2008 Aug 7;337:a288. doi: 10.1136/bmj.a288.

探讨寻求乳房重建手术的女性在获得护理和选择方面的不平等：一项定性研究。

Exploring inequalities in access to care and the provision of choice to women seeking breast reconstruction surgery: a qualitative study.

机构信息

Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.

出版信息

Br J Cancer. 2013 Sep 3;109(5):1181-91. doi: 10.1038/bjc.2013.461. Epub 2013 Aug 8.

DOI:10.1038/bjc.2013.461
PMID:23928662
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3778305/
Abstract

BACKGROUND

Breast reconstruction (BR) may improve psychosocial and cosmetic outcomes after mastectomy for breast cancer but currently, few women opt for surgery. Reasons for this are unclear. The aim of this qualitative study was to explore access to care and the provision of procedure choice to women seeking reconstructive surgery.

METHODS

Semi-structured interviews with a purposive sample of patients who had undergone BR and professionals providing specialist care explored participants' experiences of information provision before BR. Interviews were transcribed verbatim and analysed using the constant comparative technique of grounded theory. Sampling, data collection and analysis were performed concurrently and iteratively until data saturation was achieved.

RESULTS

Both patients and professionals expressed concerns about the provision of adequate procedure choice and access to care. Lack of information and/or time, involvement in decision making and issues relating to the evolution and organisation of reconstructive services, emerged as potential explanations for the inequalities seen. Interventions to improve cross-speciality collaboration were proposed to address these issues.

CONCLUSION

Inequalities in the provision of choice in BR exist, which may be explained by a lack of integration between surgical specialities. Pathway restructuring, service reorganisation and standardisation of training may enhance cross-speciality collaboration and improve the patient experience.

摘要

背景

乳腺癌乳房切除术可能会改善心理社会和美容结局，但目前很少有女性选择手术。原因尚不清楚。本定性研究旨在探讨寻求重建手术的女性的护理途径和提供手术选择。

方法

对接受过乳房重建且提供专业护理的患者进行了有针对性的半结构式访谈，探讨了患者在进行乳房重建之前获得信息的经验。访谈逐字记录，并使用扎根理论的恒定比较技术进行分析。抽样、数据收集和分析同时进行并反复进行，直到达到数据饱和。

结果

患者和专业人员都对提供足够的手术选择和获得护理表示关注。缺乏信息和/或时间、参与决策以及与重建服务的演变和组织相关的问题，被认为是导致不平等的潜在原因。提出了改善跨专业合作的干预措施来解决这些问题。

结论

在提供乳房重建选择方面存在不平等现象，这可能是由于外科专业之间缺乏整合所致。途径重构、服务重组和培训标准化可能会加强跨专业合作，改善患者体验。